DR. JACK RICHARD JR. ROOSSIEN (M.D.) – Family Medicine Physician, NPI 1184610669

Family Medicine Physician

DR. JACK RICHARD JR. ROOSSIEN (M.D.) is a healthcare provider. based in Muskegon, Michigan. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. JR050437 (MI). The NPI Number for DR. JACK RICHARD JR. ROOSSIEN (M.D.) is 1184610669

Main info

Male

41 Years Of Experience

Accepts Medicare Assignment

Name

DR. JACK RICHARD JR. ROOSSIEN (M.D.)

NPI

1184610669

Phone

(866) 611-1612

Address

PO BOX 1848

Enumeration Date

21 September 2005

Last Update Date

7 June 2019

Doctor Profile

Medical School Name

MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE

Secondary Phone

Graduation Year

1985 (41 years ago)

PAC ID

9638071632

Group Practice PAC ID

8921996307

Professional Enrollment ID

I20070511000243

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience54

Completeness75

Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. JACK RICHARD JR. ROOSSIEN (M.D.)

US Post Office - North Muskegon, 404, Center Street, North Muskegon, Muskegon County, Michigan, 49445, United States
MUSKEGON, MI 494431848
Phone: (866) 611-1612
Fax: (231) 728-4789
Type: Mailing
Stanton Street, West Olive Estates, Olive Township, Ottawa County, Michigan, 49460, United States
SUITE A
WEST OLIVE, MI 494608543
Phone: (616) 296-1020
Fax: (616) 296-1030
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49443)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 8921996307View full group profile

Name	Specialty	State
MICHAEL BANKA (MD)	-	MI
SEAN M CUNNINGHAM (DO)	Family Practice	MI
MEREDITH ANNE HEINLEIN (DNP)	Nurse Practitioner	MI
MR. KEVIN M KILEY (MD)	-	MI
DR. DAVID G BOOTH (MD)	-	MI
DR. JAMES P TWESTEN-OTOOLE (MD)	Addiction Medicine, Family Practice	IL
DON CAMPBELL (MD)	-	MI
VALERIE S CONRAD	-	MI
JAMES GRACE (MD)	-	MI
DR. GEORGE SCOTT RENTON (D.O.)	-	MI

Reviews

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Frequently asked questions

Does DR. JACK RICHARD JR. ROOSSIEN (M.D.) share an NPI with anyone else?

NPI numbers are unique to each provider or organization — DR. JACK RICHARD JR. ROOSSIEN (M.D.) uses 1184610669.

Is DR. JACK RICHARD JR. ROOSSIEN (M.D.) still practicing?

DR. JACK RICHARD JR. ROOSSIEN (M.D.) is currently listed as active in the public NPI registry.

What is DR. JACK RICHARD JR. ROOSSIEN (M.D.)'s primary classification?

Family Medicine Physician is the headline specialty for DR. JACK RICHARD JR. ROOSSIEN (M.D.) here. Clinical services aligned with this taxonomy classification.

Does DR. JACK RICHARD JR. ROOSSIEN (M.D.) list a practice location?

Patients near Muskegon, Michigan may find DR. JACK RICHARD JR. ROOSSIEN (M.D.) in results; validate coverage separately.

Why does DR. JACK RICHARD JR. ROOSSIEN (M.D.) have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.